Though capacities for preparedness and emergency response within the public health system have increased during the past six years, justifiable concerns persist. The lack of meaningful indicators of effectiveness and efficiency in response to emergencies continues to impede attempts to measure "readiness" among states and localities. The University of Pittsburgh Preparedness and Emergency Response Research Center (UP-PERRC) will conduct research to generate criteria and metrics for measuring the effectiveness and efficiency of preparedness and emergency response systems with applications for both evidence-based preparedness planning and information-based emergency response decision- making. UP-PERRC will conduct multi-disciplinary research with a unifying foundation in complex adaptive systems modeling. While intending results for all hazards response systems, UP-PERRC will focus initially on infectious disease outbreaks of varying intensity and scale;later in the funding period, additional hazard types will be added according to the priorities agreed upon by the practitioners, policy makers, and researchers. The geographic settings for four Research Project Arms will combine national, state-specific, and region-specific settings, permitting attention to urban, suburban, rural, and mixed demographic areas. Research advisors will include experts from Carnegie-Mellon University, the Public Health Foundation, and the Walsh Center for Rural Health Analysis as well as emergency planners and managers, public health agencies, the judiciary, hospitals, and private business interests. UP-PERRC will produce criteria and measures for performance improvement, model laws and ethical standards, a modeling tool for planning, and a modeling tool for decision-support during emergency response. UP-PERRC will build the numbers of experienced researchers and new investigators and will fund pilot studies to attract additional funding from other sources. Other outcomes include the uptake of performance improvement criteria by public health agencies, the enactment of model statutes and ethical standards, and the use of modeling and decision-support tools by practitioners and policy makers.